171 research outputs found

    Explaining job satisfaction and job control: a survey among finnish psychiatrists

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    Background: Job satisfaction has a major impact on mental health and job performance. Additionally, expected work satisfaction may influence choice of specialization within medicine. Methods: A postal survey was conducted in 2009 among the members (N=1398) of Finnish Psychiatric Association. Out of the members 1132 were still working-aged. All in all 64.8% (N=738) of the working-aged members returned the survey. Only psychiatrists and residents were included in the final cohort of the study (N=665). Factors associated to work satisfaction were studied and a principal component analysis was conducted on factors reported to disturb working. The correlations of factors scores with job satisfaction and job-control were analyzed. Spearman correlation coefficients were calculated between factor scores and work satisfaction. Results: Most respondents (73.8%) were satisfied with their work. Job satisfaction showed a negative correlation with increase in pace of work (rho=-0.24, p&lt;0.001). Job control correlated positively with job satisfaction (rho=0.46, p&lt;0.001). &quot;Working conditions&quot; factor explained 28.6%, &quot;leadership&quot; 8.8%, &quot;failure without support&quot; 7.8%, fear at work 6.5% and &quot;patient records&quot; factors 5.9% of the variation of perceived harmful factors at work. &quot;Working conditions&quot; and &quot;leadership&quot; factors showed the strongest and most significant negative correlations with job satisfaction (rho= -0.45, p&lt;0.001, rho=-0.32, p&lt;0.001, respectively. &quot;Working conditions&quot; associated strongly and significantly with job control (rho=-0.57, p&lt;0.001). Conclusion: Job satisfaction may be better than expected among psychiatrists considering the findings of prevalence estimates of burnout in various other studies. However, employers should put emphasis on matching employers and type of work to promote well-being of their employees.</p

    Expression of carbonic anhydrase IX suggests poor response to therapy in rectal cancer

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    Contains fulltext : 80703.pdf (publisher's version ) (Closed access

    Change in β2-agonist use after severe life events in adults with asthma: A population-based cohort study Life events and bronchodilator usage among adults with asthma

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    Objective: This prospective, population-based cohort study of 1102 Finnish adults with asthma, examined whether exposure to stressful life events is associated with the intensity of usage of inhaled short-acting beta(2)-agonists.Methods: Survey data was collected by two postal questionnaires. Baseline characteristics were obtained in 1998 and data on 19 specific stressful events (e.g. death of a child or spouse or divorce) within the six preceding months in 2003. Exposure to life events was indicated by a sum score weighted by mean severity of the events. Participants were linked to records of filled prescriptions for inhaled short-acting beta(2)-agonists from national registers from 2000 through 2006. The rates of purchases of short-acting beta(2)-agonists before (2000 2001), during (2002 2003) and after (2004-2006) the event exposure were estimated using repeated-measures Poisson regression analyses with the generalized estimating equation.Results: Of the 1102 participants, 162 (15%) were exposed to highly stressful events, 205 (19%) to less stressful events. During the 7-year observation period, 5955 purchases of filled prescription for inhaled short-acting beta(2)-agonists were recorded. After exposure to highly stressful events, the rate of purchases of beta(2)-agonists was 1.50 times higher (95% confidence interval (CI): 1.05, 2.13) than before the stressful event occurred. Among those with low or no exposure to life events, the corresponding rate ratios were not elevated (rate ratio 0.81, 95% CI: 0.66, 0.99 and 0.95, 95% CI: 0.83, 1.09 respectively).Conclusion: An increase in beta(2)-agonist usage after severe life events suggests that stressful experiences may worsen asthma symptoms

    Early retirement from work among employees with a diagnosis of personality disorder compared to anxiety and depressive disorders

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    Objective: Risk of retirement from work before statutory retirement age among employees with personality disorders is unknown.Method: We used diagnoses of awarded medical rehabilitations and hospitalisations to select two clinical cohorts from a population of 151,618 employees: participants in rehabilitation (total N=1942, 233 personality disorder, 419 anxiety disorder and 1290 depression cases) and hospitalised patients (N=1333, 354, 126 and 853, respectively). Early retirement from work was tracked through national registers during a period of 5 years. Cox proportional hazard models were used to examine the association of diagnostic groups with risk of early retirement.Results: In models adjusted for age, sex and socioeconomic position, the relative risk of early retirement for patients with personality disorders was 3.5-fold (95% CI 2.1 to 5.8) in the rehabilitation cohort and 2.3-fold (95% CI 1.6 to 3.5) in the hospital cohort compared with anxiety disorders. The corresponding hazard ratios of early retirement for personality disorders compared with depressive disorders were 1.1 (95% CI 0.8-1.5) and 1.7 (95% CI 1.4-2.1), respectively.Conclusions: Personality disorders increase the risk of early retirement at least to an equal extent as depression and more than twice that of anxiety disorders.</p

    Awareness of hypertension and depressive symptoms: a cross-sectional study in a primary care population

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    Objective: To investigate the association of hypertension awareness and depressive symptoms, and to analyse factors predisposing aware hypertensives to depressive symptoms.Design: Cross-sectional study in a primary care population.Setting: Cardiovascular risk factor survey in two semi-rural towns in Finland.Subjects: Two thousand six hundred seventy-six middle-aged risk persons without an established cardiovascular or renal disease or type 2 diabetes.Main outcome measures: Depressive symptoms, previous and new diagnosis of hypertension.Results: Hypertension was diagnosed in 47.9% of the subjects, of whom 34.5% (442/1 282) had previously undetected hypertension. Depressive symptoms were reported by 14% of the subjects previously aware of their hypertension, and by 9% of both unaware hypertensives and normotensive subjects. In the logistic regression analysis, both the normotensive (OR 0.62, 95% CI 0.45–0.86) (p = 0.0038) and the unaware hypertensive subjects (OR 0.54, 95% CI 0.35–0.84) (p = 0.0067) had lower risk for depressive symptoms than the previously diagnosed hypertensives. Among these aware hypertensives, female gender (OR 3.61, 95% CI 2.06–6.32), harmful alcohol use (OR 2.55, 95% CI 1.40–4.64) and obesity (OR 2.50, 95% CI 1.01–6.21) predicted depressive symptoms. Non-smoking (OR 0.57, 95% Cl 0.33–0.99) and moderate leisure-time physical activity compared to low (OR 0.53, 95% CI 0.33–0.84) seemed to buffer against depressive symptoms.Conclusion: Depressive symptoms are common in hypertensive persons even without comorbidities, if the person is already aware of his/her hypertension. Many modifiable, lifestyle associated factors may contribute to the association of hypertension and depressive symptoms.</p

    Employment status and differences in the one-year coverage of physician visits: different needs or unequal access to services?

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    BACKGROUND: The dichotomy employed vs. unemployed is still a relevant, but rather crude measure of status in current labour markets. Also, studies concerning the association of employment status with health have to specify the type of the employment as well as the characteristics of the unemployment. This study aims to reveal differences and potential inequalities in physician visits among seven groups in the core-periphery structures of the labour markets. METHODS: A total of 16 000 Finns responded to a postal survey in 2003. Their visits to physicians in public primary health care, occupational health care, private health services, hospital outpatient clinics and dental care services during previous year were measured as indicators of service utilisation. Participants were classified as employees having a permanent or fixed-term and full-time or part-time contract and as those experiencing short-term, prolonged or long-term unemployment. Differences in the one-year coverage of physician visits between these groups of employees were analysed using logistic regression analyses where differences in the need for services were controlled for by including demographics and self-rated health assessments in the models. RESULTS: Permanently employed respondents had visited a physician most often, and the need-adjusted regression models showed significantly lower odds ratios for a visit among fixed-term employees (OR 0.65, 95% CI 0.53–0.81) and in particular among the long-term unemployed (OR 0.21, 95% CI 0.14–0.31). A stratified analysis according to health care sector showed the lowest odds ratios in occupational health care and private physicians (ORs between 0.05 and 0.73) and also low odds ratios for dentists (ORs between 0.45 and 0.91), whereas visits to public primary health care were more common among non-permanent employees and the unemployed (ORs between 1.46 and 2.39). CONCLUSION: The use of physician services varies according to labour market status, being relatively low among the non-permanently employed and the unemployed. This underuse is emphasised when clinical need is taken into account. The main reasons for the variance evidently lie in the structures of the Finnish health service system. The result may indicate non-optimal health care of the population on the periphery of the labour market, but it may also reflect the importance of employment status as a context for need and the decision to visit a physician

    Digital Gaming for Improving the Functioning of People With Traumatic Brain Injury: Protocol of a Feasibility Study

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    The specific outcomes such as primary outcome measures were selected because they are widely used psychological tests and thought to be sensitive to changes in the cognitive functions related to TBI.</p
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